Moderate acute malnutrition (MAM) is caused by insufficient nutritional intake (both, quality and quantity) due to inadequate food availability or disease.Although several nutritional interventions have been effectively used to treat MAM, the optimal nutritional composition for treating MAM is still debated (1). The quality and quantity of protein are known to be important for growth in children, and studies have suggested that animal source protein improves nutritional outcomes in undernourished populations (2). Milk and dairy products are known to be important for child growth. Both interventional and observational studies have provided evidence that milk products positively affect linear growth. However, the exact mechanisms by which milk and its components stimulate growth are not clear. Potential candidates are bioactive peptides found in milk proteins, insulin-like growth factor, and various minerals, including calcium and zinc (3).Milk proteins, whey and casein, are very high quality proteins, and are rich in Branched-chain amino acids (BCAA) (4). BCAA are metabolized by muscle, which in turn conserves the need to breakdown lean tissue for energy. This is important in the recovery from acute malnutrition, as one of the goals to recovery is building lean tissue mass(4). Milk proteins and whey protein in particular, also have several health benefits such as enhancing immune system responses (4). Another advantage of whey protein is that it is water soluble, mixes easily, and is rapidly digested (5).A recent randomized, double-blind controlled clinical trial studied the effectiveness of whey-based compared to soy-based ready-to-use supplementary food (RUSF) in 2259 Malawian children on recovery from MAM (1, 6). Participants were randomly assigned to receive a whey-based RUSF or soy-based RUSF. The total amount of protein provided by the soy RUSF was approximately 50% higher than that of the whey RUSF in each dose the children received. The percentage of children with MAM who recovered was higher in the whey RUSF group than the soy RUSF group (81% vs 84%, for soy and whey RUSF, respectively, P = .039). Furthermore, secondary growth outcomes, including MUAC at final visit, MUAC gain throughout treatment, WHZ at final visit, WHZ change throughout treatment, and weight gain, were superior among the children who received the whey RUSF versus the soy RUSF. Even though the whey RUSF contained less protein and energy than the soy RUSF, it was more effective in children with MAM.These results suggest the potential beneficial outcomes of including whey and other dairy products in supplementary foods in the treatment of MAM. However, further studies are needed to determine the best composition (quality, source and quantity) of proteins required to match the physiological demands of children during recovery from MAM. References:Stobaugh H. Maximizing Recovery and Growth When Treating Moderate Acute Malnutrition with Whey-Containing Supplements. Food Nutr Bull. 2018 Sep;39(2_suppl):S30-S34.Roberts JL, Stein AD 2017. The Impact of Nutritional Interventions beyond the First 2 Years of Life on Linear Growth: A Systematic Review and Meta-Analysis. Adv Nutr 8(2):323-336.Yackobovitch-Gavan M, Phillip M, Gat-Yablonski G. How milk and its proteins affect growth, bone health, and weight. Horm Res Paediatr. 2017;88(1):63-69.Jäger et al. International Society of Sports Nutrition Position Stand: protein and exercise Journal of the International Society of Sports Nutrition (2017) 14:20.Wilson J, Wilson GJ. Contemporary issues in protein requirements and consumption for resistance trained athletes. J Int Soc Sports Nutr. 2006;3:7–27.Stobaugh HC, Ryan KN, Kennedy JA, et al. Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial. Am J Clin Nutr. 2016;103(3):926-933. See More